NIH to create translational research center

BY GEOFFREY HUNT

The National Institutes of Health announced in December that a new center focused on improving the translation of basic research to clinical care and therapeutics would be formed. Provisionally named the National Center for the Advancement of Translational Sciences, the center is set to commence operations in the fall.

The National Institutes of Health got an early start on spring cleaning when it was announced in December that a new center focused on improving the translation of basic research to clinical care and therapeutics would be formed. Provisionally named the National Center for the Advancement of Translational Sciences, the center is set to commence operations in the fall and will be composed of extant research programs currently spread across the NIH. However, the center does not arrive without controversy, as the effects of the proposed reorganization of funding priorities and the structure of other institutes and centers remain unclear.

Where are you going? Where have you been?

Reshuffling institutes and centers is nothing new at the NIH. Beginning with the establishment of the National Cancer Institute as the first stand-alone component in 1937, the NIH has continued to proliferate as subsequent congressional authorizations have expanded the agency’s focus wider and wider. The period between 1980 and 2000 saw a flurry of reorganization at the NIH as existing departments were renamed and merged and others were created. But after the formation of the National Institute of Biomedical Imaging and Bioengineering in 2001, critics warned that the agency had become overly fragmented, leading some, including former NIH Director Harold Varmus, to push for consolidation of the 27 individual institutes. However, a 2003 study published by the National Academy of Sciences recommended against major reorganization.

The same report advised small-scale changes, including the formation of a clinical research center as part of a broader proposal to increase cross-disciplinary translational research programs. The proposal recommended that the new center subsume the National Center for Research Resources, which contains an array of resource programs ranging from the Biomedical Technology Research Centers and instrumentation grants to nonhuman primate and invertebrate animal resources. Former NIH Director Elias Zerhouni implemented a number of those initiatives, most notably the NIH Roadmap, but left the NCRR as a stand-alone entity.

Still, questions lingered as to whether the organization of NIH enabled the agency to fulfill its mission to advance science to improve public health effectively. When the NIH came up for reauthorization in 2006, Congress created the Scientific Management Review Board, an advisory panel charged with assessing the agency’s organizational efficiency.

In 2010, current NIH Director Francis Collins asked the SMRB to study how the agency could better promote translational research. In November, the board gave its response, concluding that translational research “could benefit from a reorganization at NIH to capitalize on emerging scientific opportunities, recent changes in therapeutics development, existing resources and programs.” On Dec. 7, the formal recommendation was delivered and the National Center for the Advancement of Translational Sciences was born.

Lost in translation?

A 2006 law limiting the overall number of NIH departments meant that the creation of NCATS would require that another institute or center be sacrificed. NCRR would finally meet its maker and be dissolved, leaving its programs to be cannibalized by the other NIH institutes. Some of the NCRR's programs, most significantly the Clinical Translation Science Awards program, will be incorporated into NCATS. Collins has placed the fate of the other orphaned programs in the hands of a special task force.

As for funding, the budget for NCATS is expected to be 1 percent to 2 percent of the overall NIH budget, which approximates the amount currently set aside through the NIH Common Fund for the translational research-focused NIH Roadmap. NCATS will house several Roadmap programs, including the Molecular Libraries program and the program for Rapid Access for Interventional Development, as well as the Cures Acceleration Network, a new program authorized (though not yet appropriated) by Congress to speed the development of disease cures.

Shifting funds to NCATS will require adjustment of additional budgets, including those at other institutes and centers; it is unclear if the NCATS programs, including CTSA, will retain their current budgets.

The best-laid plans …

Congress has been notified of the recommendation and has 180 days to object; otherwise, the new center will be approved. Although the new center currently lacks a director, plans continue to move forward as the NIH once again makes itself over to fulfill its mission.